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Updated: Jul 11, 2026
Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
Transformation of childhood MDS-refractory anemia to acute lymphoblastic leukemia
Ruchika Goel1, Rajive Kumar, Sameer Bakhshi
1Department of Medical Oncology, Dr B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Myelodysplastic syndromes (MDS) are clonal disorders of hematopoietic stem cell. Patients have a deteriorating course with about 30% evolving into acute leukemias usually of the myeloid phenotype. Evolution into acute lymphoblastic leukemia is a rare and intriguing phenomenon seen in far less than 1% of adult cases, and extremely rare in pediatric population. We report a case of childhood MDS-refractory anemia transforming into acute lymphoblastic leukemia after an interval of 21 months since presentation and being on cyclosporine therapy for 9.5 months. The case raises further questions about the biology of MDS and the potential role of cyclosporine in leukemic transformation.
Insights
Childhood myelodysplastic syndromes (MDS) rarely transform into acute lymphoblastic leukemia. This case highlights a rare pediatric MDS transformation to acute lymphoblastic leukemia during cyclosporine therapy, prompting further research.
Area of Science:
- Pediatric Hematology
- Oncology
- Stem Cell Biology
Background:
- Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders.
- MDS commonly progresses to acute myeloid leukemia, but transformation to acute lymphoblastic leukemia (ALL) is exceptionally rare, especially in children.
Observation:
- A pediatric case of MDS-refractory anemia is presented.
- The patient received cyclosporine therapy for 9.5 months.
Findings:
- The child with MDS transformed into acute lymphoblastic leukemia (ALL) 21 months after initial presentation.
- This represents an extremely rare event in pediatric MDS.
Implications:
- This case underscores the rare but possible evolution of pediatric MDS to ALL.
- It raises questions regarding the underlying biology of MDS and potential therapeutic influences, such as cyclosporine, on leukemic transformation.
